Pharmacology: Anti-Infective and Musculoskeletal Drugs Flashcards
Exemplars of Anti-Infectives
- Penicillins
- Aminoglycosides
- Fluroquinolones
Pharmacodynamics of Penicillins
(Oxacillin)
- bind with protein-binding proteins which results in destruction of the cell wall
- bactericidal in nature
- interfere with cell-wall synthesis leading to cell death
- broad spectrum of antimicrobial activity
- treat gram-positive, gram-negative, and anaerobic organisms
Pharmacokinetics of Penicillins
(Oxacillin) (Anti-infective)
- absorbed variably in GI tract
- widely distributed throughout the body including lungs, liver, kidneys, muscle, bone, urine and placenta
- metabolized to a limited extent by the liver
- 60% excreted unchanged by the kidneys
Nursing Considerations for Penicillins
- higher incidence of anaphylactic reactions
- given on empty stomach (one hour before or two hours after meals)
- refrigerate oral suspension
- inject IM in large mass muscle
Aminoglycosides
(Anti-infective) (Gentamicin)
- absorbed poorly from GI tract; most often given parenterally
- distributed widely; crosses the placental barrier but not the blood brain barrier
- when administering with penicillins, the cell wall is altered allowing the aminoglycoside to penetrate the bacterial cell and increase drug effectiveness
Nursing Considerations for Aminoglycosides
- given via IM or IV routes
- peak and trough levels typically drawn
- effective against gram-negative bacilli, hospital-acquired infections, UTIs, CNS infections
- Side Effects: neuromuscular reactions, GI disturbances, ear + renal toxicity
Fluoroquinolones
(Ciprofloxacin)
- well absorbed via oral route, not highly protein bound, minimally metabolized in liver, excreted primarily in urine
- interrupts bacterial DNA replication stopping reproduction
- drugs in this category treat a variety of infections in specific organs
- many drugs in this category have negative effects on body systems
Nursing Considerations for Fluoroquinolones
- assess for suicidal tendencies or depression
- some oral forms can be take with food
- should be taken 2-4 hours before or 2-6 hours after antacids or other products containing calcium, iron, zinc, magnesium, or aluminum
Adverse Reactions with Fluoroquinolones
- dizziness
- nausea + vomiting
- diarrhea
- abdominal pain
Fluoroquinolones: Due to Adverse Reactions Instruct patient to
- drink a lot of fluids
- monitor bowel function
- avoid sun to prevent photo-toxic reactions
- monitor for CNS effects
- avoid hazardous tasks
Musculoskeletal Drugs Exemplars
- Bone Reabsorption Inhibitors
- Disease-Modifying Anti-rheumatics (DMARs)
- Skeletal Muscle Relaxants
Types of Bone Reabsorption Inhibitors
- calcitonin
- calcium supplements
- selective estrogen receptor modules (SERMS)
Bone Reabsorption Inhibitor: Calcitonin
used for treatment of postmenopausal osteoporosis, hypercalcemia r/t hyperparathyroidism, or Pagets disease (osteitis deformans)
Bone Reabsorption Inhibitor: Calcium Supplements
- absorption of calcium is facilitated by vitamin D
- risk for hypercalcemia, kidney stones
Bone Reabsorption Inhibitor: Selective Estrogen Receptor Modules (SERMS)
- activate estrogen receptors in bone to decrease bone loss and block estrogen receptors in breast tissue decreasing risk of recurrence of estrogen receptor positive breast cancer
- prevent and treat post-menopausal osteoporosis + breast cancer
